Assessment of factors associated with mortality among visceral leishmaniasis and malaria co-infected patients in Northwest Ethiopia: A retrospective study

Abstract

Introduction: Visceral leishmaniasis(VL)and malaria co-infection is common in VL endemic areas. The occurrence of this two parasitic disease simultaneously occurred on the same host at a time resulted in sever clinical presentation and poor or delayed prognosis and finally may lead to death. It is reported that there is co-infection of these two disease in all endemic regions of the world. Objective: The objective of this study was to identify factors associated with mortality among visceral leishmaniasis and malaria co-infected patients from 2010-2016 in northwest Ethiopia. Methods: A retrospective study was carried out. Data were extracted from routinely collected patient’s records by Medicines Sans Frontiers Holland between 2010and 2016 in northwest Ethiopia. A total of 123VL-malaria co-infected and 387 VL-Mono infected randomly selected patient’s record were reviewed. Data were entered into EPI INFO 7, analyzed using SPSS. Both bivariable and multivariable logistic regression analysis was done. A p-value less than 0.05 was taken as statistical significant with 95% confidence level. Results: A total of 510VL patients’ medical records reviewed, 123 VL-malaria co-infected and 387 VL mono infected patients were studied. Among them 25 deaths recorded (10 from exposed group 15 from none exposed group), with case fatality rate of 8.1% and 3.8% respectively. Malnutrition (AOR=69.11: 95%CI: 3.39, 1406) and splenomegaly (AOR: 0.16, 95%CI 0.04, 0.86) were associated with the mortality. Conclusions and Recommendation: Malnutrition and splenomegaly was associated with the VL-malaria coinfection associated deaths. Health professionals should be good enough when doing physical examination, balanced and adequate nutrition for co-infected patients is very mandatory.